title: Burden and typing of rotavirus group A in Latin America and the Caribbean: systematic review and meta-analysis.
abstract: The efficacy of licensed rotavirus vaccines has only been shown against certain rotavirus group A (RV-A) types. It is critical to understand the burden of rotavirus gastroenteritis (RVGE) and its prevalent types to assess the potential impact of these vaccines in Latin America and the Caribbean (LA&C). We performed a systematic review and meta-analyses of all the available evidence reported from 1990 to 2009 on the burden of rotavirus disease and strains circulating in LA&C. Eligible studies--185 country-level reports, 174 951 faecal samples--were selected from MEDLINE, Cochrane Library, EMBASE, LILACS, regional Ministries of Health, PAHO, regional proceedings, doctoral theses, reference lists of included studies and consulting experts. Arc-sine transformations and DerSimonian-Laird random-effects model were used for meta-analyses. The proportion of gastroenteritis cases due to rotavirus was 24.3% (95%CI 22.3-26.4) and the incidence of RVGE was 170 per 1000 children-years (95%CI 130-210). We estimated a global annual mortality for 22 countries of 88.2 (95%CI 79.3-97.1) deaths per 100 000 under 5 years (47 000 deaths).The most common G type detected was G1 (34.2%), followed by G9 (14.6%), and G2 (14.4%). The most common P types detected were P[8] (56.2%), P[4] (22.1%) and P[1] 5.4%, and the most prevalent P-G type associations were P[8]G1 17.9%, P[4]G2 9.1% and P[8]G9 8.8%. In the last 10 years, G9 circulation increased remarkably and G5 almost disappeared. More recently, G12 appeared and P[4]G2 re-emerged. To our knowledge, this is the first meta-analysis of rotavirus infection and burden of disease in LA&C.
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Virology Section. Belém, Brazil. alexandrelinhares@iec.pa.gov.br.
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Linhares
authors.forename: Juan A
authors.initials: JA
authors.lastname: Stupka
authors.forename: Agustín
authors.initials: A
authors.lastname: Ciapponi
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Bardach
authors.forename: Demián
authors.initials: D
authors.lastname: Glujovsky
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Aruj
authors.forename: Agustina
authors.initials: A
authors.lastname: Mazzoni
authors.forename: Jefferson A Buendía
authors.initials: JA
authors.lastname: Rodriguez
authors.forename: Analía
authors.initials: A
authors.lastname: Rearte
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Lanzieri
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ortega-Barria
authors.forename: Romulo
authors.initials: R
authors.lastname: Colindres
mesh_terms: D017691:Caribbean Region / Q000453:epidemiology; D004196:Disease Outbreaks; D005759:Gastroenteritis / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control / Q000821:virology; D005838:Genotype; D006801:Humans; D015994:Incidence; D007843:Latin America / Q000453:epidemiology; D015995:Prevalence; D012401:Rotavirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000821:virology*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology; D016019:Survival Analysis
chemical_list: D022243:Rotavirus Vaccines